DEP/DUA/1/15/15 (Transcript version)

Janet McKenlie

(1777-1778)

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Janet McKenlie.

A case respect nature of which much divid in opin between two suppos.

And these to consid degree affect both practice & prognosis.

Here princip compl of patient consist in cough & dyspnoea.

This attended also with general debilit appearance of exhaust. habit, & expectorat to consid extent of viscid yellow matter.

All these known to be sympt of that affect very fatal about period of life to which this pat arrived Phthisis.

But occurr also in affect [merely] catarhal.

And when that the case danger much less consid.

Treatmnt also in some partic varied.

Especially where as in pres. instance is supposed ultim to proceed from another affect.

For here will observe that all compl. of patient ultim rreferrd to obst. of menst.

This circum however may have influ as inducing either one or other of affect. [men]

Or indep of this either one or other may occurr. merely as concom. of obst. of menst disch.

And may have arisen from action of same cold upon surface to which interrupt of natur course of that evac ascribd.

But if distinct between catarrh & Phths of import. in pract not less useful as [leading] to prop. judgem in prognos.

When catarrh recent or phthis far advancd certain judgem. may be easily pron.

But freq. transit from one to other.

And very diffic. to disting with certainty during interm stages.

Such an inst now occurrs in case before us.

Here no one sympt or combin of sym on which absol. dep. can be put.

Every partic occuring in the disease as far as can be derivd from hist. given us, may be merely catarrhal.

At same time, when consider insid nature of Phthis pulmon. have ground have ground for suspect suspect that may already have made consid advan.

And must own that am rather disp to believe this may really be case.

Here one partic which if certainly ascert. would put matter quest beyond all doubt.

That is pecul. nature of mattr expect.

In history of affect is [describd] as of yellow colour.

And may probab from circum of gen. connex. presume that not of very fluid consist.

In this state then has general appear of two fluids in nature very diff. P & [Muc]

If howevr in any degree of former is to be consid as certainly Phthisic.

If entirely of latter may be be catarh.

Must indeed be admitted that vomic may exist in lungs from which no disch.

And these although matter at pres. expector. purely mucus yet patient may in reality be subj. to Phthisis.

When this howevr the case for most part cough without expectorat.

And especially when as in inst now before us is attended with fixed pain.

If then matter expect merely mucus probab. that dis. entirly catarrhal.

And on this ground all sympt may may readily be expl.

But if in expect mattr even mixt of pus are without any hesit to [pronoun] affect certainly phthisic.

Must then appear that for all such calls an accur. distinct between pus & mucus of greatest utilit.

For this purpose in writings of med. pract. many diff. marks pointd out.

And besides gener. appear. of fluid expect. its colour, taste, smell, partic on [burning] but above all specif. gravit pointd out as disting marks.

The last cheifly ascertaind by observing whether sinks or swims in water.

And this perhaps, especially as tried by Hippoc, one of best

While pus sinks in water, mucus usually swims.

And if in place of common water we employ as was done by Hyppoc. salt water or [use] mixt of salt & water test less doubtful.

But in any way by no means a certain mark.

For mucus in reality a fluid specif grav. of which greater than that of com. water.

And only observd to swim in conseq. of having air attachd to it.

Same also may happen of very viscid pus.

Thus then while mucus entirely freed from air bubles will sink, pus by aid of these may rise to surf.

This uncert. in common means of disting these fluids induced a [Societ] of medic practit here to which I have the honour to belong to prop. the discovery of proper test as subj of prize medal.

And is with partic pleas. I can now inform you that their intent has not been frustrated.

At least among other test one is proposd which if exper. accurate, or if same chem relat hold with regard to other pus & muc will put this mattr beyond all doubt.

And if same chemic relat. hold with regard to other pus & mucus as with that empl. in exper. to which allude may be able to say with cert. whether [exp] matter does or does not cont any mixt of [Pus].

Who is author of this dissertat will not be known till lettr which accom it be opend.

And this will only be done if the prize shall be adjudged to it.

But whether other Gent be adjudged the other Gent. on whose sentim this must dep. shall be of same opin with me or not appreh. shall [natur] rob this auth of gain or reput. by now ment. his test.

Especially as period allowd for receiv. farther dissert. now elapsed.

Test which he proposes is by aid of Caust alkal. Lixiv & of Vitriol acid.

By either of these according to his exper certain determ may be formd.

From experim & deduct which constit greatest part of this dissert. he concludes that if any one has expect. matter contents of which he wishes to ascert. let him diss. a portion of it in Caust Alk. Lixiv. or Vit. Acid.

Let him add pure water to both solut.

And if mixt. remain [limpid] is evid that fluid expect. merely mucus.

But if in both cases an evid depos of matter to bottom of vessel is certain test that expect. matter cont. pus.

Since read this dissertat. have had one opport of putting this test in pract.

Not indeed with matter expect by pres. patient who lives at distance from Ednr. but with another under our care. viz Ann Mason of whom shall afterwards speak.

From this trial both disp. to conclud that test a good one & to pronounce in that case a very unfav. prognos.

Matter [record] of white colour, of [thick] consist. & very consid degree of viscid.

Much greater indeed than commonly case with pus.

Was however as far as I could discov. with without manif. offens or foetid smell.

And did not even shew such on burning.

Dissolved portion of it in Caust. Alkal. and anoth portion in vitriol acid.

For this solut. space of some hours with agitat at times was requis.

And after all though appar. [intim] combind yet in both consid viscid.

On addit of water, in both solut very consid sedim fell to bottom.

And in that with vitriol acid besides this depos. a matter rose to surface

An appear. which by way may observe is remarkd to happen in dissert. to which have alluded where pus & muc. united.

From these trials then led to conclude that in pres. case expector to consid degr purulent.

In conferment of trial wishd to see how far common test gave evid of pus.

And found that when part of this matter put into pure water in very short time sunk to bottom.

To see also what would be affect of mucus in circum in which had put the matter expect by our patient dissolvd some of it in caustic alkali obt by being blown from nose.

On addit of water solut. perfect clear. & without sedim

From these circum then led to conclude that test prop. a good one

And that the matter which had exam containd consid proport. of pus.

Have not yet had opport of trying in this manner the matter expect by pres patient.

But hope that may have it in powr to examin it before next lect.

And shall then pres. with result of trials together with what farther observat have to offer on this case